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KEY POINTS

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  • Asthma is a condition that may go into remission or present differently throughout stages of life. The presence of airway inflammation remains a consistent feature.

  • Symptoms of asthma are preventable and manageable with lifestyle modification and, when needed, medication therapy.

  • To achieve optimal outcomes, the MTM consult process must include patient education on trigger avoidance and self-management techniques.

  • MTM providers should assess use of inhaler(s) and device(s) during each visit to optimize technique and ensure maximal efficacy of asthma pharmacotherapy.

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INTRODUCTION TO ASTHMA

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Asthma is a disease characterized by airway inflammation and obstruction. In individuals with a genetic predisposition, the airways become inflamed and hyperresponsive when exposed to various environmental triggers, resulting in bronchoconstriction, formation of mucus plugs, and airway obstruction. Common symptoms of asthma include cough, dyspnea, wheeze, and chest tightness. Asthma is one of the most common chronic diseases, with an estimated 300 million individuals affected worldwide.1, 2 Although a common health condition, the clinical presentation may be highly variable due to the intrinsic nature of the disease. Thus, global measures were created to assist clinicians in disease state management (Table 13-1).

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Table 13-1.Overview of Global Measures of Asthma Assessment1
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For asthma patients who are not currently taking a long-term controller medication (also known as maintenance medication), symptom severity is assessed using the impairment and risk domains illustrated in Table 13-2. To determine whether a patient is presenting with intermittent, mild, moderate, or severe asthma impairment, the following factors are reviewed: nighttime awakenings, use of short-acting bronchodilator for quick relief of acute symptoms, work days missed, patient ability to engage in normal daily activities, and quality of life assessments. In general, patients are considered at higher risk for uncontrolled asthma if they have a history of 2 or more asthma exacerbations requiring treatment with oral corticosteroids. Patients who ...

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